Levels Of Sexual Risk Behavior Research Articles

LATENT CLASS ANALYSIS OF RISK BEHAVIORS AMONG BAHAMIAN YOUNG ADOLESCENTS: RELATIONSHIP BETWEEN VALUES PRIORITIZATION AND LATENT CLASS

To explore an association between values and risk behaviors among early adolescents, baseline data from 689 Bahamian youth (median age = 10) were collected from the Portrait Values Questionnaire (Schwartz et al., 2001) and The Bahamian Youth Health Risk Behavioral Inventory. Latent class analysis identified three classes of youth in differing patterns of risk behavior: (7.8%) high levels of drug and delinquency risk behaviors; (2.8%) high levels of sexual risk behavior; (89.4%) low risk takers. Results showed low risk takers included more females, while at least twice as many males comprised the two risk behavior classes. ANOVA found Benevolence, Conformity, Security, Tradition and Universalism values were associated with low risk takers, and logistic regressions for ordered categorical (ordinal) dependent variables showed both values and latent class predicted intentions for future risk behavior. Latent class analysis and values assessment are discussed as tools to guide adolescent riskreduction interventions.

A new meeting place: chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men

To describe the process of Internet chatting, and subsequent dating and sexual (risk) behaviour among Dutch men who have sex with men (MSM), and to compare the demographic profile of the Internet sample with a traditional Dutch MSM sample. A self-selected anonymous Internet sample. Enrolment via a prominent gay chat room. Potential respondents were asked to complete an online questionnaire about chatting and dating, and sexual (risk) behaviour with their last date via chatting (e-date). In 26 days, 5302 questionnaires were returned. Of these, 4984 were evaluated as reliable and were used in the analyses. Eighty-two per cent chatted at least once a week, 88% had ever dated through chatting, and of these 89% had had sex with one or more e-dates. With respect to the last e-date, almost 50% had had anal sex with their last e-date, and 15% reported unprotected anal sex. Especially among HIV-positive men, a high percentage of unprotected anal sex was reported (39%). After correcting for the disclosure of HIV status, this percentage remained twice as high compared with HIV-negative and never-tested men (28 versus 14%). Compared with a traditional MSM sample, the Internet sample was significantly younger, and comprised more non-Dutch and bisexual men, whereas the level of sexual risk behaviour with casual partners was comparable. The Internet is a popular new meeting place for MSM, and attracts men with a different demographic profile. The level of risk behaviour warrants that opportunities for interventions on the Internet are explored, with special attention to HIV-positive chatters.

Female Methamphetamine Users: Social Characteristics and Sexual Risk Behavior

ABSTRACT The primary objective of this research was to expand our knowledge regarding the personal and social characteristics of female methamphetamine (meth) users, their motivations for using meth, patterns of meth use, medical and social problems associated with meth use, and the relationship between meth use and sexual risk behaviors. The sample consisted of 98 HIV-negative, heterosexually-identified, meth-using females residing in San Diego, California. Female meth users were characterized by personal and social disadvantage, high rates of psychiatric symptomatology, and high levels of sexual risk behavior, including multiple partners, risky partner types (e.g., anonymous sex partners), and high rates of unprotected vaginal and oral sex. Meth use was also associated with the subjective positive experience of sex. These finding suggest that behavioral interventions should be tailored to the social characteristics of female meth users, and program content should reflect the intertwining of women's sexual experience and meth use.

Abuse Experiences in a Community Sample of Young Adults: Relations with Psychiatric Disorders, Sexual Risk Behaviors, and Sexually Transmitted Diseases

This study documents significant associations among lifetime abuse experiences, psychiatric diagnoses, and sexual risk behaviors in a multiethnic community sample of young men and women (N = 1803) in South Florida. Self-report data were collected via structured interviews as part of a longitudinal follow-up of a larger school-based study. Participants were grouped according to extent of lifetime abuse experiences. Cumulative lifetime abuse experiences were associated with increased risk for a broad range of individual lifetime psychiatric disorders, as well as cumulative lifetime psychiatric disorders. Both cumulative abuse experiences and cumulative psychiatric disorders were independently associated with (a) higher levels of sexual risk behaviors and (b) higher risk for lifetime sexually transmitted diseases (STDs). Implications for selective prevention of sexual risk behaviors and STDs among young adults with histories of abuse and psychiatric disorders are discussed.

Patterns of HIV risk behavior and condom use among youth in Yaoundé and Douala, Cameroon.

This study describes the levels of sexual risk behavior and condom use among Cameroonian urban youth in order to evaluate the need for reproductive health programs targeting youth and to inform the design of such programs. We use data from a survey conducted in July-August 2000 among a representative sample of 1,956 unmarried youth aged 15-24 years. The data show that in urban Cameroon, first intercourse often occurs at an early age. Despite the HIV epidemic, a substantial fraction of youth, particularly males, continue to have high rates of partner change. A substantial fraction of youth consistently use condoms with casual partners. However, consistent condom use in regular relationships remains low, even though many youth have multiple regular partners. These findings illustrate the need for youth-targeted reproductive health programs in urban Cameroon. To ensure that youth are reached before they adopt risky behaviors, there is a need for programs that target very young teenagers and emphasize consistent condom use.

Conditions for widespread heterosexual spread of HIV in the Russian Federation: implications for research, monitoring and prevention

Sexual transmission of HIV from injection drug users (IDUs) to their non-IDU sex partners has been clearly documented as an important public health issue. The extent to which such ‘first-wave’ sexual HIV transmission will generate HIV epidemics within the wider heterosexual population is of importance for prioritisation, design and targeting of preventive interventions. In Russia, factors which will influence the scale of sexual HIV transmission outwards from IDUs include: (a) HIV prevalence and incidence among IDUs; (b) the extent and patterns of sexual mixing between IDUs and non-IDUs; (c) levels of sexual risk behaviour in these partnerships; (d) sexually transmitted infection (STI) type and prevalence in IDUs and non-IDUs. The size and behaviour of the ‘bridging population’, which interacts with both IDUs and the general population, as well as STI prevalence, sexual mixing patterns and sexual risk behaviour within the general population, will be crucial in determining the scale of heterosexual HIV spread. More empirical research, in conjunction with mathematical modelling of the transmission dynamics of HIV/STIs, is necessary to better understand the role of these factors in determining the nature and extent of HIV epidemics in different contexts. In Russia, there is a current need for research on bridging groups, particularly female IDU sex workers and their male clients, and for implementation of second generation surveillance, including monitoring of HIV/STI rates and risk behaviour in well-defined representative samples from both high risk groups and the general population. The many gaps in currently-available data make precise predictions of the future scale and extent of the HIV epidemic in Russia difficult. Nevertheless, existing evidence suggests that continued rapid spread of HIV among IDUs will occur, and that there is a greater risk of significant diffusion of HIV into and within the heterosexual population than has been seen as a result of IDU-associated epidemics in North America and Western Europe. Effective, high-coverage interventions aimed at simultaneously reducing injecting and sexual risk behaviour among IDUs and sex workers, as well as interventions aimed at the populations which interact with them, particularly clients of sex workers and young people, are urgently required.

Patterns of sexual risk behaviors and psychiatric disorders in a community sample of young adults.

This cross-sectional study documents significant associations between patterns of sexual risk behaviors and psychiatric diagnoses in a multiethnic community sample of young adults (N = 1803) in South Florida. Self-report data regarding sexual behavior and psychiatric symptoms were collected in structured interviews in a follow-up of an earlier school-based study. Cluster analysis was used to group participants with regard to levels of sexual risk behaviors during the past year. Chi-square analysis and ANOVA identified significant associations between cluster membership and (a) lifetime and (b) past year diagnoses for affective disorders, conduct disorder, antisocial personality disorder, alcohol abuse/dependence, marijuana abuse/dependence, and other drug abuse/dependence. In addition, higher levels of sexual risk behaviors were associated with higher levels of cumulative lifetime psychiatric disorders. Implications for selected prevention of sexually transmitted diseases (STDs) and the treatment of psychiatric disorders in young adulthood are discussed.

Sexual and drug use behavior among women who have sex with both women and men: results of a population-based survey.

Recent HIV/AIDS trends in the United States suggest a relative increase in HIV infections among women attributed to injection drug use or heterosexual contact.1 Although the biological risk of female-to-female sexually transmitted HIV is unknown, it is thought to be much lower than the risk of transmission between men and women, including instances in which a condom is used.2 However, studies focusing on women who have sex with women (WSW) have shown that some subgroups of WSW exhibit high levels of sexual risk behaviors with men as well as unsafe injection drug use.3,4 Thus, if risk assumptions are based on self-reported or presumed sexual identity, possible risks for HIV infection may be underestimated in some subgroups of WSW. Few studies have estimated the proportion of WSW or characterized their behavior in samples representative of the population as a whole. Here we describe sexual and drug use behaviors associated with HIV and other sexually transmitted diseases (STDs) among WSW who took part in a door-to-door, population-based survey of women aged 18 to 29 years. The survey was conducted between April 1996 and January 1998 among residents of low-income neighborhoods in Northern California. Study methods have been described in detail in a previous article.5 Of 2547 women who completed the study, 2229 (88%) reported sex exclusively with men, 189 (7%) reported sex with both men and women, and 16 (1%) reported sex exclusively with women. Of the 7 HIV-positive women, 4 reported only male partners, 2 reported both male and female partners, and 1 reported only female partners. None of the 16 WSW who reported sex exclusively with women reported any injection drug use. Therefore, analyses of risk were limited to those who reported sex with both men and women and those who reported sex exclusively with men (Table 1 ▶). TABLE 1 —Prevalence of Sexual Behaviors, Injection Drug Use, and STD/HIV Infections: Population-Based Survey, Northern California Compared with women who had sex exclusively with men, women who had sex with both men and women were significantly more likely to report past and recent high-risk sexual behavior, including sex with an HIV-positive man, multiple male sexual partners, sex with a man who has sex with men, sex with an injection drug user, trading of sex for drugs or money, and anal sex. They were also more likely to report past and recent injection drug use, including use of heroin, cocaine, and speed. Finally, they were more likely to have serological markers for both hepatitis B virus (anti-HBc, HbsAG, or both) and hepatitis C virus (anti-HCV). Rates of HIV and other STDs did not significantly differ owing to the small numbers of these infections. The rates of sexual and injection drug risk activities exhibited by women in this population-based survey who reported sex with both men and women place this group at potentially higher risk of HIV and other STDs than women who were exclusively sexual with either men or women. Prevention efforts should avoid assumptions based on reported sexual identity and should acknowledge that women who report sex with both women and men may be at increased risk for HIV and other STDs.

Participation in Athletics and Female Sexual Risk Behavior

Researchers have reported that female athletes exhibit lower levels of sexual risk behavior than female nonathletes. The present study explored four causal structures relevant to such associations. Potential mediators and confounds included physical development, educational aspirations, self-esteem, attitudes toward pregnancy, adolescent involvement in a romantic relationship, age, ethnicity, and social class. Data were analyzed for a sample of female adolescents in Grades 7 through 11 using the National Longitudinal Study of Adolescent Health in a two-wave panel design. A statistically significant association between the occurrence of a pregnancy and sports participation was reduced to statistical nonsignificance when certain demographic confounds were held constant, suggesting a spurious association between the variables. Pregnancy attitudes were found to account for the association between sports participation and sexual activity. Finally, sports participation interacted with paternal relationship satisfaction to predict pregnancy, with the father variable having a larger impact for athletes than nonathletes.

Condom acceptance is higher among travelers in Uganda.

To examine the role played by mobile residents in the spread of HIV through rural Uganda. Travel history and sexual network data were collected from a random sample of 1627 residents aged 15-49 years in Rakai District, Uganda during 1994. Travelers and non-travelers are compared with respect to socio-demographic attributes, risk exposure, knowledge, attitudes and use of condoms using descriptive statistics and multivariate logistic regression. A demographic profile of travelers' partners is developed using information from a local network survey module. The population is highly mobile, with over 70% reporting travel to a potentially higher risk destination in the past year. Travelers are somewhat more likely to have higher levels of sexual risk behavior, but the risk appears to be offset by significantly greater knowledge, acceptance, and use of condoms. In multivariate analysis, the sexual risk differential for travelers is explained by occupational exposure and higher socio-economic status. The differential in condom acceptance, by contrast, appears to be associated with travel itself. Condom use with non-spousal partners is three times higher among travelers than non-travelers (P< 0.001), and travel remains a significant predictor after controlling for age, education, residence, occupation and multiple partners. Travelers are more likely to use condoms with both their local and non-local partners. Partners of male travelers are likely to be younger and better educated than those of male non-travelers. The mobile population in this rural region appears willing to adopt risk reduction measures appropriate to their exposure. This suggests that targeting condom promotion programs to travelers and their partners is likely to be effective in reducing the spatial diffusion of HIV, and may be an efficient method for spreading behavioral change into rural areas.

Sexual, contraceptive, and drug use behaviors of women with HIV and those at high risk for infection: results from the Women's Interagency HIV Study.

To document the sexual and contraceptive practices of women with HIV infection or who are at risk for infection. Data on the baseline behaviors of 561 HIV-negative and 2040 HIV-positive women were collected as part of the Women's Interagency HIV Study (WIHS). WIHS is a multisite, longitudinal study following the natural history of HIV infection among women in the United States. Each participant contributed an interviewer administered, self-report interview including questions on sexual and contraceptive behavior. Women with HIV were less likely to report heterosexual activity in the previous 6 months (65% HIV-positive, 76% HIV-negative). Among sexually active women, there were no differences in the proportion of those reporting vaginal (97% HIV-positive, 98% HIV-negative) or anal sex (12% HIV-positive, 10% HIV-negative), although women with HIV were less likely to report cunnilingus (41% HIV-positive, 70% HIV-negative) and fellatio (48% HIV-positive, 57% HIV-negative). Of women with HIV, 63% always used condoms during vaginal sex (versus 28% HIV-negative), with lower rates reported during other sexual activities. Crack, cocaine, or injecting drug use, reported by 27% of HIV-positive and 35% of HIV-negative women, was associated with inconsistent condom use, independent of serostatus. HIV-positive women who reported using condoms and another contraception method were less consistent condom users (57% consistent versus 67%). The prevalence of sexual risk behavior in this sample suggests that, although women with HIV exhibit lower levels of sexual risk behavior than uninfected women, many have not been successfully reached with regard to implementing safer behaviors. These findings have implications for more widespread and effective behavioral intervention efforts.

Temporal trends in HIV risk behaviors of out-of-treatment injection drug users and injection drug users who smoke crack.

This study compared the baseline sociodemographic characteristics and HIV risk behaviors of two groups of out-of-treatment injection drug users (IDUs): 366 who concurrently smoked crack (smoking IDUs) and 212 who did not smoke crack (IDUs) in the past 30 days. Temporal trends in recent risk behaviors were also assessed for each drug user group over an 18-month period, January 1992 through June 1994. Baseline data were collected in South Philadelphia before the implementation of a multisite HIV intervention research project funded by the National Institute on Drug Abuse. For the temporal trend analysis, the sample was grouped into four intake periods based on the date of the baseline interview. The results indicated that although both groups were economically disadvantaged and at high risk of HIV infection and transmission, smoking injectors had fewer economic resources and were at a moderately greater risk because of higher levels of sexual risk behaviors. Analysis of temporal trends revealed few reductions in drug risk behaviors and none in sexual risk behaviors. This study points to the need for examining differences between types of drug users, developing appropriate multidrug treatment programs and assessing the characteristics of communities so that theory-based interventions can be tailored for maximum effectiveness.

Role Play Assessments of Sexual Assertiveness Skills: Relationships with HIV/AIDS Sexual Risk Behavior Practices

Conceptual formulations of HIV risk reduction and many HIV prevention interventions reported in the literature emphasize the role of sexual assertiveness, negotiation, and communication skills as key elements for enacting behavior change. However, there have been few attempts to determine if objective ratings of individuals' sexual communication skill effectiveness are actually associated with their levels of HIV sexual risk behavior. In the current study, 114 severely mentally ill men and women role-played scenes in which confederates simulated attempts to coerce unprotected sex. Participants' role-played responses were transcribed verbatim and later rated for quality in several areas of assertiveness skill effectiveness. In addition, participants provided detailed information concerning their sexual behavior practices in the past 30 days. Participants were categorized into highly, intermediately, or poorly skilled groups based on effectiveness in role play performance, and the groups were then compared on indices of HIV risk behavior. Individuals with high objectively rated sexual assertiveness skill had the lowest number of unprotected sex acts, the smallest number of different sexual partners, the smallest number of casual sex partners, and the highest levels of condom-protected sex in the past 30 days. Individuals with poor sexual assertiveness role-play skills had the highest levels of sexual risk behavior. These associations were especially pronounced among women. Findings of this research provide support for teaching individuals to develop and refine their sexual assertiveness and communication skills in HIV prevention programs. Future research issues in this area are highlighted.

Detection of the hepatitis G virus genome among injecting drug users, homosexual and bisexual men, and blood donors.

The recently identified hepatitis G virus (HGV) is parenterally transmitted; the impact of sexual transmission is unknown. Moreover, it is unclear what proportion of HGV-infected persons may develop persistent viremia. Sera from injecting drug users (IDUs), non-drug-injecting homosexual and bisexual men with high levels of sexual risk behavior, and blood donors were tested for HGV RNA and hepatitis C virus (HCV) RNA by reverse transcriptase-polymerase chain reaction and for antibodies to human immunodeficiency virus, hepatitis B virus, and HCV. HGV RNA was detected in 33% of IDUs (n = 130), 11% of homosexual and bisexual men (n = 101), and 2% of blood donors (n = 90). HGV RNA seroprevalence significantly decreased with increasing time since first drug injection, whereas the seroprevalences of both HCV RNA and anti-HCV antibody increased. Thus, a high proportion of HGV-infected persons may clear the virus and develop protective antibodies. The relatively high HGV RNA prevalence among non-drug-injecting homosexual and bisexual men indicates that sexual contact may be another important route of HGV transmission.

The relationships between sexual behavior, alcohol use, and personal network characteristics among injecting drug users in Baltimore, Maryland.

Studies on the relationship between alcohol consumption and HIV-related risk behaviors report inconclusive and contradictory results. This study sought to examine the relationship between drug and alcohol use, personal network characteristics, and sexual risk behaviors. A sample of 290 injecting drug users in Baltimore, Maryland, were interviewed. More than half the males and 28% of the females reported multiple partners within the prior 6 months, and 33% of the males reported exchanging money or drugs for sex. For males, heavy drinking was significantly associated with multiple partners, exchanging money or drugs for sex, and casual sex. The personal network characteristics of size and density, as measured by the percentage of network members who knew each other, were associated with sexual risk behaviors. These results indicate that among injecting drug users in Baltimore, heavy drinkers, and those with larger, lower density personal networks have increased levels of sexual risk behaviors.